Glowing

Work has been odd, albeit more peaceful, these last weeks. One woman who left on vacation right before the fired tech(FT) had her come-apart at the manager, came back today, and stories had to be told. The surgeon I scrubbed for had also not heard the story - but had been asked to write a letter of recommendation for FT.

I asked, "I hope it wasn't glowing."
"I wouldn't think so," he answered.

Which is to say, he kept it guarded and a smart manager or HR department would easily have seen it as hardly a recommendation. But we also heard she'd been hired, so maybe they deserve her. Odd thing, surgeon also said he told our manager not to hire FT, and FT bragged loudly that surgeon was her buddy and loved her and they went way back - when she was first hired. And now we are hearing that all the surgeons were complaining about her, but manager dismissed their concerns. As well as ours. Charming.

You'd think, in this economy, a good job would attract a lot of good people. Hard to understand how our pool of applicants is so small. The ball is being dropped somewhere in the process.

Slower this week, and last. The first lull we've had in a very long time. Not unwelcome.

Goodness

Yesterday was a Good Day. Worked with a great scrub, a surgeon that is difficult but doable, everything flowed well - no technological or supply glitches to mention. Dscrub and I were late last week, the last case, alone, by five hours. This week looked to be shaping up much the same, but the surgeon finished up way ahead of schedule, and we actually got out a smidge early. When I got home D tells me our friends Mike and R are in town for a very short visit, but might stop by, and he got to have lunch with them at the Red Iguana, and brought me home leftovers. This was nearly too much good news for me to handle. So I took a shower and we tidied up, with an eye toward having two children running about. At 7 & 4 years, less of a safety issue.

Now, Mike* & R have a well deserved, and groomed reputation for being late. So I automatically added an hour or two to their proposed arrival time, which proved to be slightly optimistic, but not too much, since we were also prepared for them not to make it at all. Both kids immediately ran down the hall and more or less made themselves at home with little noise or fuss. After greetings, making tea, and adults talking, I got them the toys (a small box with some figures, magnets, marbles, cars) play-doh, crayons and paper, and they pretty much kept themselves occupied. Bright, polite kids, and my admiration for our friends is right off the scale. Oh, I know part of it is their natures, but the other half is the parents not damaging it, or letting it run wild, and this is the kind of family everyone loves to be around. Moby made his usual polite appearance, then settled in the next room. M, the 7 year old girl would have preferred a cat that would be held, but that is not this cat. They have four cats at home, so I assume she did not take it too much to heart.

And we actually had good grown-ups conversation, with the kids included once in a while. I got M some cocoa, left it in the kitchen with her figuring she would bring it in the living room when it was cooled enough. Realized shortly after that she probably wasn't allowed, mentioned this to R, who confirmed. Went back into the kitchen to tell her she didn't HAVE to drink it there, she had the mug still up on the counter and stood with it, assured me "I want to drink it here." Seemed perfectly happy, so I said fine and let her be. P, at four, delighted that we had an Iron Giant figure, and he played with it, and the play-doh for hours. He had much to say about Iron Giant.


Mike so much the same, he and D chatted about all the usual subjects. It's taken me a very long time to warm up to R, always more or less liked her, but didn't feel a connection. Last evening there was something softer about both of us, and I found myself really wanting to be around her.

Moby eager to chase after they'd gone.

All day, aware it was Good Friday, it seemed wonderful just not to have to be in church all day. Holy Week hurt when I was a kid, and in catholic school, we were in church with my class every day as well as in church with my mother all weekend. No choice, I suffered through, bringing out of it only a deep self discipline. And a gladness that I never have to do that again. But I was thinking last night, if he died on Friday, and rose after three days, why is he back walking around on Sunday morning? I know I've never been great at arithmetic, but even I think something is wonky there.




*Mike and Dave get to keep their own first names here, because they have more anonymity with them. How many Daves and Mikes do you know?

Cheese

Attitude problem,
A struggle to keep going,
So tired, don't wanna.



This is a week I could have used a holiday, but there are none until the end of May. Hoped to get off a bit early today, no chance, there until the bitter. Have to take my BLS class tomorrow, then go to work. I've been doing CPR pass off since 1988, and although there have been changes, improvements based on data, I've kept up. The updates should take an hour at most, not five. But I am a month past the lapse, missed due to the move and our office manager got no notices that I was late - as she usually does. Ultimately my own fault, but there were circumstances.

Letting go is an awkward process. The right one for me, of that I am sure. I will not be compared to my abusive father, I will not accept the blame for how I was treated as a small child under his control. They are free to see it differently, I am not subject to their skewed reality. My family is D and Moby and our friends. My genetic kin is on their own, nothing to me. I leave them chained to their own fates. So often I was told what I "had" to do. Mostly, those were lies. No, I didn't have to. No, I do not owe.

As John Cheese says, "I think there's a point where you're allowed to let that shit go to voice mail."

Tarts

Listening to I've Never Seen Star Wars, while the victim, or guest, who tries pop-tarts for the first time - actually likes them. I think I had them a time or two at Aunt Alma's, it's the kind of thing she would have done for me. Mostly I know I got to eat them while doing market surveys at the downtown mall when I first came to this city. We interviewed a lot of little kids, which is a bit like hitting one's head against a brick wall, but more painful. We were required always to ask "anything else" and write down the answer, until they said "no." This is the one time no kid will say "no." They will just make stuff up, or repeat themselves, endlessly. Most of us would just stop asking, and write down "no." Hell, this was about fuckingpoptarts, dammit.

To do the interview, we would heat and present cut up bits of poptart, in varying flavors, leaving halves left over, that we all would nibble on. Minimum wage folks, students, marginal all in our own ways, it was food, more or less. Most of us still got rather sick of it very quickly. One guy did not. We wound up having to get more supplies for the 'study' because he would snarf it down, even stealing whole packages. Later, D would talk about a guy he gamed with, who another friend called a "food vacuum" because no snacks were safe in his presence, and no one else would get any. Probably not the same guy.

I can't imagine eating them today. Or pot noodles, as the INSSW show made Sandi Toksvig try. Not sure if the pot noodles are analogous to Ramen noodles, but I assume so.

Made lunch for D's parents, enchiladas, salsa refried rice, salad. Thrown together, no recipe as such, but they turned out well, and D's dad effusive in his praise of my cooking. Nice talk, more comfortable over the years. We had a little plumbing moment this morning, and I got an unexpected, clothed, cold shower down my arm. We sorted that, more or less. Got the second ceiling fan down and replaced - in the music room. Got a foam board to put up more of our postcards, which I found looking for other paperwork. We spent part of this evening doing arts & crafts. A collage. No adhesion yet, but laid out for morning.

Coal

Woman at work doing the minimum possible to keep from being fired. Not really my business, except when it directly and measurably is. Always an excuse, always someone else to blame, always the most work to circulate for. Has not taken any definitive steps to actually solving the problems, only surface changes, stop-gap lip-service, which is where I lose my patience. I report (only) the clearly reportable to the supervisor, mostly to protect the other scrub techs who she dumps work on. I can deal with moderately inept scrubs, but add in the malicious, neglectful attitude, and how it affects those who prefer not to say anything, and I feel a responsibility to the techs who are so capable and attentive and hard working. Certainly she will consider me a tattle-tale and a crank. She has great "self esteem" based on what she wants to be, not how she actually is.

All in all, it's all very sad. She has no idea how incompetent she is, how inconsistent. I was rooting for her to sort it out, because she's not stupid, she's just assumptive and entitled. Maybe that's not as amenable to correction as I'd hoped. Poor woman, if only she opened her own eyes to herself. But that's her job, and no one can do it for her.
_______________________________________________________________________________________


Thinking about scripts a lot this week, people living according to shoulds, twisting around their realities according to expectations. About holidays, weddings, houses, jobs, money, siblings, children. And how D and I have resisted and waited and transformed the assumptions. We met and became completely attached, then lived together, eventually married, changed my name years later - even to finally taking a middle name. Worked, then went and got degrees. Getting our first house in our 40s. Never wanted children, either of us. Bless the good parents, but don't count us in. We've done it all backward, but it feels right. Who knows what might be next?

Burn the scrips, throw them on the fire.

A couple of people at work right before I left, made a point of telling me how much work a house was going to be. (Not that anyone commenting here would do that... Phil*. ) Well, duh. Both of us grew up in houses, I've painted and drywalled and mowed, and stoked a coal furnace, painted the garage myself one summer, and everything else. D has much the same experience, aside from the coal. We are both thoughtful adults who know (more or less ) what we are getting into. Work, but for ourselves, and the Cat. We've chosen carefully, we've thought about this over many years. Telling us, "houses are work" is the same as saying "you have not thought about this, you idiot" in the same way as all those who told us we should buy a house when we were renting. Make up their fucking minds.

Marriage is hard, so those same kind of people say. Well when it's good, it's not hard work. It's attention and care, effort - but not a chore. Having children (for us would be) - miserable, but not for those who love it, and have a good match in their children. How many people think they should tell others that they SHOULD have children, like it has never occurred to them? Well, we are not kid people, never have been, never will be, not going to change because someone says "Oh, you Should!"

Oh, well, we never thought about that very important and personal decision, I guess we should have kids! Silly us! And we should never own a house because it's too much work. We should never have moved to Boston because it's SO Expensive! Cats destroy everything, never have a cat! Never get married, it's so hard!


Long ago, worked with a woman in her 30's having her first child, convinced it would not change their lifestyle at all - anyone pulling her aside, holding on to her shirt, screaming, "NO, Everything is going to CHANGE!" would be forgiven.

We are not doing that. We have a list of Things We Need to Do, and Things We Would Like To Do (some long term. Including having a train track around the top edge of the room.† ) We have a pretty good handle on it, after so many years. We are buying at the Bottom of the market, at a great interest rate. Unlike if we'd bought when everyone was telling us we HAD to buy a house.


We are up for this. We can do this, we are not stupid or deluded. "Everyone" is wrong. Everything you know is wrong. Know why you are doing something, it's not work at all.

And what if we die before the mortgage is done? Once we've rented it from the bank, but had space enough? What heirs need we worry about? Thirty years from now, or forty, or fifty? What difference? Now, to have space, and wood to resonate my own voice, and D's guitar, bliss.

Hopefully photos tomorrow, from us and the inspector. A day later - if I have to stay at work. I go in to work after 3, because I promised to cover for another RN, for the day, long ago, and completely forgot. But they covered for me, because I have to meet the sewer and house inspector at 10 and noon, & they got staff from the Main - but not after eight hours. Fair enough, they could have insisted I cover the shift, rightfully so. Tis the season. Monday off. Boxing Day. Works for me, as I will indeed be boxing up stuff.


Christmas would have been nice. I'll be doing Packing instead. Party for Groundhog Day in February. It's becoming official. I want someone to say, "You've lived here how long? And it looks this good?" D hedged, "well, if we get it that good." I sneered at him. Really. He knows better. I has a talent, I has skillz. It will be impressive.

Not enough chairs, though.







*Just joshing, Phil‡.
†How cool would that be?

‡And you get your own footnote to boot.

Abrasives

Tis the season when whatever has been put off is best used to take advantage of one's deductible, and there are the holidays to take off for healing. ORs are often most busy this time of year. We have picked up remarkably, which is good and exhausting together. For a week with random sleep, and too much to think about, both of us overwhelmed, the extra hours are also abrasive. Last night up several times, woke and could not settle again, slept a while, up again. Not restful.



Dr. A wrote a scrip for a thumb splint, which I was able to get fitted for in a gap between cases. It does feel better this evening. It looks fluid, but it is quite stiff, and protected my joint from the work of the day. Yes, I did get to pick the color.

Every year, she brings in really lovely grapefruit for each of the staff at Christmas, making no secret of her appreciation for our work. This year, it got delivered incorrectly, and non-staff helped themselves, instead of our office manager making sure everyone got one. I got missed, when she found out, she brought one in for me especially. She really didn't have to, no one's fault, but I am very grateful. I'll eat it whole tomorrow, with gusto.



I kept up, laughed, paid attention. A wave of weight and vague illness hit about 1600, only subsiding after I was home a while, eating D's lovely goulash stew, spicy and flavorful. I find myself full on very little food, then ravenous a few hours later, wondering why I didn't just have more at mealtime.

Too much sugar at work, mostly resistible, if only for the glut that induces revulsion in me. Only that I was so hungry did I indulge at all, really.

Air reportedly improved, but so foggy. The light on the way home, just at sunset, pinks and oranges on the grey, through the murk, stained rather than pretty. Ruined light, muddied horizon. Supposed to be clearer soon.

The House Inspector poking around the house on Wednesday, and we meet with him once he's done. Says we'll have 100-200 photos of his work. Should be interesting. D had to deal with more requirements, paperwork, today. It's been a rough week on both of us. This evening, Moby staying close, very nearly sat on D's lap, stood on it for a while, then curled between us, getting up, as we got up, came back several times.



Shared my old Thank You joke several times today, half heard by one, encouraged to pray the whole litany again.

Grassy Ass, mercy buckets, and donkey shines.

Proverbs

Busy, busy day, and me the runner. I wrapped blankets to be sterilized, I rolled bias dressings because they were out, I turned over rooms - opening for the scrubs, making beds, shifting equipment. I gave breaks and lunches and cleaned and ran. I scrubbed in at 3, which was a bit of quiet relief in comparison. No wonder moving is not as daunting for me, it's no worse than a long day at work.

We have allowed ourselves a week to do the move. Closing on the 13th, which is a conference day for our surgeons, and we will likely only be running one room anyway, so getting it off was a piece of proverbial cake. Ta (ladi) dah! To move in on the 17th. Looks like we are going to have to have a Groundhog Day party, as I have been joking about doing for years, since there is no way I'm putting up and taking down a christmas tree as I pack up our stuff. Maybe I will put it up for the new place. Maybe. But we should be settled in sufficiently by then, knowing me. February 2 is a Thursday, so it'll have to be the Saturday after. Close enough.

It's kind of an ideal move, only a few stairs, two blocks away, from a small place into a larger one, not just one day. This, by the standards of a move, is going to be more, proverbial cake. It probably won't snow every day that week.

Thumb is much improved. But Dr. A, who I would have preferred to take care of this, but Dr. Tigger is hard to refuse, has told me I should have a hard splint, especially during the move. She was going to write a scrip for me to take up to the hand clinic, but I missed her before she left today. I'll catch her next week, and will follow her directions. Going to continue to baby it for a while, as it heals. Thumbs are best well cared for. Very important, opposable thumbs.

Going to bed early, to sleep, to recuperate. Inspection on Wednesday. Title being checked. Will start the packing process Saturday.

Moby still blissfully unaware, although we've told him. He'll know something is up when the boxes start stacking.

Faster!

Faster, Pussycat! Kill! Kill! *

We got our official Yes this evening, and some tight deadlines. Gah, and yikes, and huzzah. Will learn more tomorrow, details and commitments. D will start to bring home boxes from work. I'll get some packing tape. Going to be a tight year for cash. But we will have a house.

Exchanging letters with my younger elder brother. He's really trying, and I know the quality of his heart, if not the nature of his personality, after so many years. Writing all going there, careful words, expressive words, real words. Striving for compassion and honesty. It's going to be a long road, I will walk it for now. No destination, only the journey.

Dr. Tigger injected my sore thumb today, corticosteriods, for some inflammation that has persisted. He also did x-rays, the quick ones like we use in the OR. No arthritis, a tight joint space, but nothing extraordinary, just one of those overuse issues. Our core tech guy was right behind me, a kind of staff clinic this afternoon.

He kept apologizing for the needle, but I did nothing more than blink a bit. I'm a tough old broad, and I'm not about to let a little needle bother me. He'd broken scrub while his resident sewed the incision (standard practice) so I did the count with the scrub, and a bit of charting with one hand, as he poked the other. Told him if I could deal with a block in my sinuses so they could stitch up my lip, a little finger pressure was not about to phaze me. He warned me how much it would hurt, especially the next day. And I accepted this, I'd had a hip injected for bursitis when I was about 30. That hurt like mad, alarmingly so, but as that pain ebbed, so did the misery of the bursitis, and it never returned. I was up for thumb pain that would abate. Sorer all afternoon, but not so badly.

Extremely irritated that I have to go in at 0700 for a meeting tomorrow, my day off. Dammit. I'll do up the February staff schedule to make it worth the trip. I'll probably be awake at 0400 again anyway. Might as well get paid for being up too fucking early.

Fortune cookie message this evening, You will be coming into a fortune. Well, when we get the downpayment in one place, certainly. Perhaps the house is our fortune.


And, I can imagine the house. Soon to be our house. Very soon.

!

Yourself

Be yourself. One of those awful instructions given to the young. Parents, teachers, adults in general, tell them from the beginning how to be, to be good, dress them, correct them in every detail. Hard for a child to know how much of it is necessary teaching and how much the personal preference of the teacher, how much their own self. Very few parents are good at bringing out their offspring's own best character, without imposing their own, and I expect they never say, "be yourself."

Surgeons who are consistent, reliable, and communicate clearly with their staff, and welcome questions are so easy to work for, and with. The difficult surgeons who don't have a routine, are always using different equipment and supplies, ignore question and anger easily, are the ones who always say, "I do this the same way every time!" The good ones who actually are pretty much the same every time, never say that.

People who apologize saying, "I'm not usually like this," frequently are. When I find myself using that phrase, I look very closely at how I've been behaving recently.


~~~~~~~~Grossness alert ~~~~~~~~~~



Had to get on the floor, and reach under the blankets under the sterile field to attach the hose to the bair hugger warmer for a patient. S. laughed, and I said "Dignity. Always, Dignity." Yup, I got the degree, means I'm the one wiping up the floor, crawling in and under and through. For laparoscopic inguinal hernia repairs, I commonly had to get down, reach under, and make sure the testicle was in the scrotum - as opposed to anywhere else. Dignity, I'm telling you. The worst experience was going under a prone patient in a spine contraption, my head sideways, and drool went in my ear. Ugggghhh... . To this day, it still makes me shudder a little. Worse than shit, piss blood, crotch cheese, or bubbles of mucous in any other configuration.

Dignity. Part of the job.

Prepared

I was prepared to stay until seven this evening, especially after we picked up the case from the other room (to no effective gain of time.) But, J came in and relieved me, as the later shift, she'd come in at 9am to cover lunches, then relieve the last case. Which was mine. I made damn sure I got her everything she needed - stocked my suture cart, finished my charting, got her a sling, shredded my papers with patient information, cleared my detritus.

There is a winter storm on the way, I wanted to get to the grocery store before it hit. I'd called earlier, and they had turkey roll, what they call boneless turkey - which puts me in mind of Gary Larson's Boneless Chicken Farm. A good size, and easier to cook, for four people. Yes, I'm doing Thanksgiving here. It's a small place, but comfortable enough for four. I'm planning cranberry sauce (from frozen berries) yams with pineapple, scones, green beans, and whatever else I think of before Thursday morning. Pistachios for nibbles.



D got a few episodes of Mastermind, which we'd never seen before. Heard of, certainly. It's kind of awesome. People sit in a chair, and answer incredibly difficult questions about their chosen subject, then they all come back again and answer general knowledge questions nearly as difficult. D and I do passably unembarrassingly on the general ones. No fuss, no flashing lights, no buzzers, just a powerful test of one's intellect and memory and exposure.

Continuing to enjoy Inspector Montalbano, to the point of getting some of the novels. Luca Zingaretti is a joy to watch. I feel like I'm picking up a bit of Italian, but it's probably actually Sicilian.

Arrivederla.

Snuff

The day ran long, with much to do. I could have left at 430, my room was done. But there was so much to be put away, then sterile processing needed hands, so I wrapped light handles and k-wires and jergen balls. Then I cleared up one room, and as I was really going to leave, the last room was nearly done, so I stayed (as most of us do) to clean up that one as well, until 6. There is nothing so lovely as finishing late and having everyone descend and have it all put away and wiped before one can come back from giving report in Recovery. I have to say this for the folks I work with, they do the job in front of them, and they work hard, and fast. No shirking, not most of them.

Home now, we had chip & egg, with salad. Sweet potato chips, broiled, but they are very tasty. S's chickens' eggs, so especially delicious. There really is a difference with better eggs, vegetarian, uncaged chickens. It seems like a luxury, but they are so much better than the poor battery chicken eggs. And compared to the price of steak or chicken, really not more, the better (more expensive) ones. Even D, who has never been a fan of eggs, likes these. So very fresh, and I know the chickens are well cared for, including what S calls "spa treatments." They get their feet washed, to prevent bacterial infections.

Have some Epic Scotch Ale, and it's lovely. D ordered Snuff, which came today. He must love me, he's giving it to me, to read first. I'm already chuckling, and having to read bits to him. Wilikins and Drumknot are providing humor in the first few pages.

I'll be reading tonight, and tomorrow. Busy. Backsoon.

Pouncing

Watching.

He spots the ribbon.


Pounces. Cat wins. Cat always wins. Cat makes the rules of the game, which helps.


Snow and clouds, as seen coming out of work. On Thursday, when I saw how much snow stuck up there, I couldn't help laughing. The hot summer stranglehold is broken. There may yet be mild days, but the season has turned.


Scrubbed in all day, four long cases, and me aching and bruised. Swathed in x-ray gown and thyroid shield, sweating for ten hours. Glad to be home, glad of coolness. Up for several hours during the night. When I returned to bed, Moby jumped up as well, so I gave him a thorough head scritching, and he purred exuberantly, then went back to sleep on D. Snuggled so hard, D felt he was being shoved off the bed. Amazing how ten pounds of cat can have so much force, while snoring.

Twelve

A solid twelve hours work, but with good support. Lifted 64 three liter bags of irrigation fluid for four extensive joint scopes -two complex shoulder repairs, two ACL knee repairs. That comes up to handling over 400 lbs. Broke my own record of bags for a single case, from a previous 23 to a current 30. Changed out the 20L suction device 4 times on that one case. Started our last surgery after 1730, but thanks to a couple of folks staying to the bitter end of their shifts, we turned over VERY quickly.

Most of the day, I worked with P, who has very good eye language. I sometimes struggle with her accent, I have a deaf spot with a lot of Asian Englishes. But she is very good at catching my eye when she needs to communicate with me, or miming what she wants. Sometimes, she just writes me funny notes, and holds them up. And she tells me I'm rather good at picking up on her prompts. She will point, or look, and I go and check, bring her what the surgeon asked for - then I look at her to see if she already has it, and she either waves me off, or nods, and I (continue to) move. Likewise E who relieved her, gives me a word or a smile, and I respond. It's so important in this job, and a real joy when it works well. A kind of trust and respect.

From when P left at the end of her shift at 3, until E took over at 5, I had to deal with a scrub for whom this subtlety is a closed book. I feel her staring at me, but when I give her a questioning look, she rolls her eyes back. I look at the irrigation bags to check their level, and she looks at me for a while before realizing I'm not looking at her. No matter who I speak to, she answers. This is the kind of skill it is nearly impossible to teach, it has to be picked up by the observant and sensitive. Hard to describe, and those who don't get it get huffy and frustrated.

So wrung out when I got home. D made me dinner, I used the foot massager and iced my back. Moby slept on me quite a lot last night. Lots of dreams.

Shiatsu

Got a shiatsu massage on Wednesday, which both helps, and hurts - but not harms. Found lots of hot spots, I'm following up on all of them. And I will follow up with her as well, she's got a good touch. I think I've found my massage therapist, I hope when she's finished her training she stays somewhere close.

Thursday spent entirely at work, a taffy day. Sweet, but it stretched out... kept going and going and going. The nurse scrubbed in appreciated that I had everything put away by the time the patient left the room, a no inconsiderable bit of running. We were the last two staff, and I know I didn't want to stay longer than necessary. I stopped her in sterile processing to tell her the room was done, and she could just leave. This went over well. I've been scrubbed with another nurse circulating who does nothing to clean up ahead of time on late days, which keeps me from respecting her.

Friday, we'd finally managed to plan a day to meet up with Dave and K, so I asked to be out on time. This is a feature of this job, if your room goes late, you stay until it's done. I knew this at my interview before I was hired. But, one can make a particular request, and everyone does their best to help out. Ran a lot on Friday, did get out on time.

So lovely to share amazing food with two dear friends. K had the mole amarillo, which we all had to taste. Wow. I knew her to be a brave woman, but holy cajones! Nothing like hot food to lift one's mood. Next time we go there, I'm gettin' that. We didn't skirt any sad issues, but neither did we dwell on them. K played D's Martin, and Dave asked D "why two pick-ups on a Telecaster?" D was happy as a gear head asked a question. Pigs in mud got nothing on that.

Coffee

Tea is wonderful, tea is essential. Tea can be very difficult to find out in the wild, in this coffee culture. Warm water and a cheap teabag in a styrofoam or paper cup is common. Or an aluminum pot of hot water, a ceramic cup, and a small assortment of flavored tisanes and maybe one Earl Grey bag, with a few lemon slices, sugar and fake sugar packets and creamer. As though they should cover up the tiny portion of tea, which they find an unpleasant substitute for coffee. I have not tried to order tea out for many years, giving it up as a bad job. Except at Chinese restaurants, where it is always oolong, but at least it's reliably good. Indian restaurants only serve the sweet milky mix, which is probably fine, but I've never liked sweet tea. A drop of milk* I can stand, especially if I've over steeped a pot but I still want to drink it.

So often, I wished I could like coffee. But unlike most people, I can't even stand the smell of it. My father eating shredded wheat with hot coffee poured over is the most likely explanation - since that stinks of wet dog on a hot day. And I have tried to drink it, no one in the army hasn't. I'd have done almost anything on that duty to get some caffeine in me, but I couldn't manage downing a mug of coffee. D has tried as well, and had an even worse reaction than me. I did have some at a local specialty cafe, some Kenyan stuff, along with gazpacho, after a final exam. Not that I liked it much, but I figured I could get used to it. I could taste the quality, although it was not quite happy on my tongue. That place had decent tea, but the odor of coffee around reduced how much I could enjoy it.

In Boston, coffee was water of life, even the hospital cafe had good quality beverage. Dunkin' Donuts was not about pastry, it was all about the caffeine delivery system. I listened to others wax poetic, and I waited to get home to drink tea. No wonder it took me so long to stop drinking sugary cola. At this job, not only is there a coffee maker, two if you count the surgeon lounge, but someone brought in a French press, and a lot of mornings they do a batch up. At least the aroma does not fill the room.

On the other hand, the coffee maker has a hot water spigot, very nearly boiling. And I have a cubby hole to keep a ceramic mug, and a tin of oolong bags. It's not ideal, but it helps.





*Yes, I know. I can't explain this either.

Scrunch

Moby found this corner, of sorts, and scrunched himself in there. Never seen him do that before, but I guess he likes exploring his options.


Dale reminds me, as he so often does, of an aspect of my work and training that I use, but don't think to mention usually. Added to this week's patients. Not the easy, generally healthy group, more like a gaggle of odd ducks. It's not hard to spot them. Even in a hospital gown, they look disheveled, with unwashed and/or uncombed hair, long left untrimmed, or badly cut. Or when their hands or feet need to be washed, and that's where the surgery is being done. Odd, to have to take a scrub brush to a dirty foot, when the individual knew they were having an operation on that bit. I've had to do that twice this week, one hand, one foot. Got to get it clean to get it closer to sterile.

This does not include those who have a fracture that has been splinted for a while, who cannot be blamed for not wanting to get the splint wet, or jostle a painful break. Or kids, who resist being clean, nor their parent who chooses not to insist when the little monkey is injured. Likewise those who have dirty jobs, mechanics and ranchers mostly, here. Their hands are tattooed with engine oil and soil, a permanent feature. I've had those guys apologize, and I reassure them - I know it's not dirt as such.

No, the nutty ones are different. There is a smell about them, sometimes literally. They don't think to keep themselves covered as much as reasonably possible, as most others do. The one today sat, with her gown bunched up around her thighs, crosslegged on the gurney in Pre-op, blanket tossed aside. When even the most overheated would normally keep the blanket over their lap at least. They talk too much, make too little eye contact, make off-color and off-subject jokes, move erratically. They may have an odd request, without a reasonable story. A grown woman with a teddy bear, who promised her daughter to keep it with her to look after her, is unusual, but normal. A grown woman with a teddy bear who doesn't explain, and with no known mental delays - evidence of oddity. They ask many, many more questions than anyone else - even medical folks (who tend to ask a lot.) And they are often irrelevant questions, uncommon ones, more to delay than an actual bid for information. Or, they ask nothing at all, don't answer, grunt or get angry.

And I in no way include patients with known problems, brain injuries or developmental anomalies. No, the Odd Ducks are more likely to have drug issues, though. Heavy smokers, meth teeth, extensive messy tattoos, equally odd SOs, and it's never just one thing, but an array. They take longer to get ready, emerge from anesthesia unpredictably, and often have brightly colored, but grungy underwear.

They are sometimes funny, often likable, good for stories - later, with those who were there. We don't judge, but we do diagnose. It's kind of a hobby, a side effect. Like every job dealing with people, we remember the weird ones.

Altogether

When people come in to have surgery, they are not at their best. They are stripped down, vulnerable, hungry, usually a bit worried, often sleep deprived. In unflattering gowns designed for easy access for medical intervention. And we strive to both safeguard their health and safety, and then their dignity and humanity. A necessary prioritization, but nonetheless distressing.

A young student visited, at the invitation of a surgeon, to observe. Not uncommon. I helped her find her way around, get scrubs, and she disappeared into a bathroom stall to change. I had to stop myself saying something, but I left her to her privacy. We nurses all just strip at our lockers, to do otherwise would be untenable, and silly.

I remember when I first had to change into a swimsuit at the public pool, how heartstoppingly naked I felt, no matter how quickly I managed to re-dress. How appalled at the bodies of women and other girls around me, so different, so raw. My own skin so exposed. But I loved to swim so much, I came to accept, to ignore. Good training, between the army and the OR, I've had to undress and dress in public almost more often than not.

And I remember when I was small, and my dear Aunt Alma marveled at my excessive modesty when changing. She set the seed, that maybe my mother's horror about nudity may, possibly, be a bit overdone.

I am, I think naturally modest. I haven't any exhibitionist tendencies. But neither does it bother me to disrobe when it's appropriate. At the Field House at the university, in the women's locker room, was a shower room, sauna and hot tub. I would go in between two early morning classes during an hour gap, to warm up and have time to relax. No one ever bothered to wear more than a towel, and it was very comfortable.

Save once, when a group of, I'm guessing related, women trooped through, all wearing bathing suits and talking the whole time. Another woman and I who had been politely, and quietly, sharing the space, caught each other's eye, bewildered. The group did quiet down a bit, but their state of dress felt intrusive, as though blaming the two of us conforming to the usual norm of being immodest. Both of us left fairly quickly, uncomfortable.

Once in a while I read a whine about how nurses used to look so professional in those crisp white dresses and caps. And I am always exasperated. I work for my living, I get all kinds of ... stains on my work clothes. I'm on the floor, crawling around, I've ripped them on equipment.

The very thought of doing this in a dress is beyond my comprehension. To be in my own, white, clothing would be insane. However clean looking, they would not be. Scrubs are cleanable, nearly disposable. Maybe the romantics want to think of us delicately wiping a brow with a cool cloth, rather than debriding a crusted wound, cleaning up fecal matter, suctioning out mucous. I put on laundered, often wrinkled, thin cotton blend scrubs of venerable vintage, every morning of work. I take them off after every shift, and they get disinfected and recycled. Every day.

I wear an ill-fitting, functional uniform, rather like my patients. We're all in this together.

Residue

Evidence of the weekend fire. Apparently started by a campfire not adequately smothered from the day before. All out, now. This is taken from the parking lot at work, a University shuttle is visible in the lower right.

And yes, still snow in the mountains. One of the resorts was still open for skiing on the 4th.

Took the camera to work, as I am trying to take a photo every day. Here are the operating microscopes, part of a C-Arm x-ray machine, and all the (not lead) radiation aprons.

An operating table, partly dismantled. Used with a shoulder positioner earlier, and rolled into the hall for later assembly. The yellow is a gel pad. The strips are velcro to keep the foot pad in place.

Perks

My shoulder has been sore the last few weeks, so I finally had the will - and opportunity - to corner one of the surgeons for advice. It really is amazing to see anyone in full skill mode, and with someone so able and well trained, it's a kind of joy. I was able to be an oddball example, so he seemed to enjoy the challenge. Nothing like a good biological puzzle for these guys. And they tend to be very generous with their time and effort for the people they work with.

Consider it a perk.

Upshot, my shoulder is stable, probably a capsular irritation, and he gave me some stretches. Downside? I have something very strange about my bony anatomy. My shoulders do not rotate properly. I couldn't answer the "how long has it been like this?" although after I got home, I think I figured it out. Yes, I think I have. Because in Basic, when I had to do push-ups, I could not make my arms do what everyone else did, although I managed a workaround. To the point that I had no problem passing the PT test, including the push-ups.

So, I have Issues with my shoulder joint, but I'm working on reducing the pain. He seemed to think it was irritation of the capsule, which makes sense, since the muscles all work, it just hurts.

Pan

Last night:
Warm, windows open. Inside all day for me, another long day, but it's all income, and I can't complain too much. I was the runner, the opener, the turnoverer, the break giver, the clean upper. Got home by 1830, worn and welcomed.

That is the best part, that D always brings me home. Despite my fiddling with putting away my baggage and taking off shoes, and bitching about my day, he waits until I pause, then eagerly greets me and hugs me. It is a wonderful life, to be always wanted, embraced, welcomed. I am unspeakably grateful, to know where home is, always. I never forget it was not always so for me, that for long years I had no home. Twenty years on, and I still value this proof of being beloved.

I've been thinking about values, about what values matter. Certainly not family or religious values. I remember my mother talking about a new married couple choosing each other first. About how my brother didn't value family over friends. All about a vague kind of precedence. I never quite understood it. Loving one's father because he is one's father. Assuming love (should love ever be assumed?) due to genetic proximity. This very idea offends me. I've never been much motivated by money, only the security that sufficient money brings. I'm not a believer, not a joiner, not a fan of institutions as an ideal.

I value kindness, competence, serious attention to one's work, and great amusement at the vagaries of life. I value expressing love in any form as many ways as possible. I value art and wit and intelligence, as well as critical thought. I value care of the helpless, children, pets, the elderly. I value respect of those who have earned it, and gentleness for those who have not. I value discipline and self control, and those who know they have no control over anyone else. I value thoughtfulness and curiosity.

This morning:
Thinking about a discussion on another blog years ago, commenters getting hot under the collar about using a dishpan, the consensus that everyone uses them and they are useless. Their reasoning mostly in the negative - that their mother had one, neighbors, and they could not see why.

I use one, my mother did not. I remember having to plunge my hand into the cooling, greasy water to pull the plug, and retching as I did so. The water in the large sink lost heat very quickly, and I've broken glasses on the porcelain - a treacherous accident. So, when I got on my own, I bought a plastic pan to put in the sink, like my aunts did. Uses less water - that stays hotter longer. I've never broken anything on the softer material, and when I'm done, the dregs get poured down the disposal cleanly.

I remember a story from the infamous Reader's Digest, of a woman who cut the ends off the roast. (Yes, this was a very long time ago.) When asked why, she can only say she thought it has something to do with the flavor, because her mother always did it this way. The mother simply says her mother always did it. The grandmother is asked, and she replies "Because that was the only way to make it fit the pan I had."

I've never been any good at memorizing, it takes a huge amount of effort and time for me to get a short poem in my head, or a phone number. But if I know why something does what it does, why someone was given that name, why that number, it stays forever, clear and connected. It doesn't even have to be a big important why. Much of what I do at work is protocol, we do it that way because it works well enough, and simplifies complex tasks so as not to confuse others. The tourniquet has two hoses, one blue, one red. In this place, we always use the red one, unless both are needed for a bilateral surgery. Then we use Red Right, Blue Left. It really doesn't matter, as such, but prevents inflating the wrong one on both sided cases, and keeps the one not connected from being accidentally used - to no effect - on the rest.

Why do you do what you do?

Clouds gathering, proof that the mild day will be shoved aside for at least one more snowstorm. At least it doesn't stick around down here on the valley floor.